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A nurse is collecting data from a client who reports severe headache and a stiff neck. The nurse's data collection reveals positive Kernig's and Brudzinski's signs. Which of the following actions should the nurse perform first?

A. Administer antibiotics
B. Initiate droplet precautions
C. Limit visitors
D. Decrease bright lights

User Nrz
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1 Answer

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Final answer:

In the case of suspected meningitis showing severe headache, stiff neck, and positive Kernig's and Brudzinski's signs, the nurse's first action should be to initiate droplet precautions to prevent potential bacterial spread.

Step-by-step explanation:

A nurse who has a client with severe headache and a stiff neck, along with positive Kernig's and Brudzinski's signs, is likely dealing with a case of suspected meningitis. These symptoms suggest inflammation of the meninges, which could be caused by bacterial, viral, or fungal pathogens. Given the severity and potential rapid progression of bacterial meningitis, the first action the nurse should perform is to initiate droplet precautions. This is crucial to prevent the spread of potential bacterial infections through respiratory droplets. Meanwhile, the healthcare provider will likely order a lumbar puncture to confirm the diagnosis and, depending on the results, administer the appropriate antibiotics for treatment.

While the nurse awaits further orders from the physician, initiating droplet precautions to protect other individuals from the risk of infection should take precedence over symptom management strategies such as decreasing bright lights, limiting visitors, or even administering antibiotics, which should only be given on a physician's order after confirming the specific pathogen causing the meningitis.

User Whetstone
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